A credit line under a photo of a Van Gogh painting Wednesday wrongly implied that work hangs in the National Gallery of Art. It is in a private collection whose owners wish not to be named. (Published 7/ 27/90)
Vincent Van Gogh, the brilliant but tormented post-impressionist painter who at the age of 37 committed suicide 100 years ago this Sunday, has long been a pet patient of medical historians. They have been fascinated both by his extraordinary artistic vision and by the recurrent, disabling "attacks" that he vividly described in his letters.
Now, a new disease has been added to the list of Van Gogh's possible illnesses: an inner ear disorder called Meniere's disease.
This previously unrecognized ear problem, rather than the more commonly cited epilepsy or madness, may have been the reason for the dizziness and vomiting that plagued Van Gogh during the final years of his life, according to a report published in today's issue of the Journal of the American Medical Association.
The famous episode in which Van Gogh cut off part of his own ear may even have been a desperate but useless attempt to gain relief from the annoying ringing in the ear suffered by many Meniere's patients, according to the report.
Since no detailed medical record exists, would-be diagnosticians have used Van Gogh's letters, the sketchy notes of his physician, and, occasionally, clues garnered from his paintings, said I. Kaufman Arenberg, an otolaryngologist at the Colorado Neurologic Institute and principal author of the article.
Van Gogh's own doctor thought he had epilepsy, but many psychiatrists who have studied his case in recent years believe he suffered from manic-depressive illness. Other disorders that have been suggested in more than 150 articles and books on the subject include schizophrenia, glaucoma, side effects from drinking the toxic liqueur absinthe, and overdoses of the heart-stimulant drug digitalis.
Arenberg, who specializes in treating Meniere's disease, said that Van Gogh's descriptions of his symptoms strongly suggest he had the ear disorder. He said the disease, first described by Prosper Meniere in 1861, was little known among doctors in the 1880s and was often confused with epilepsy.
"He never really had a seizure disorder that we can tell," said Arenberg. "What he described fits in with the diagnosis of Meniere's disease. The strongest point in favor of that is his using the word vertige," which is French for vertigo.
Van Gogh used the word to describe his attacks in at least eight letters written between 1884 and 1890, according to the report. His dizzy spells came in clusters separated by long periods without symptoms. During a severe attack in 1889, he complained of "a bad stomach," and in other letters he reported that noise bothered him and described hearing "strange sounds." In 1889 Van Gogh committed himself to a hospital for "epileptics and lunatics" and stayed for a year.
Arenberg said such features are typical of Meniere's disease, which he estimated affects about 7 million Americans. The disorder occurs when excessive fluid accumulates in the inner ear, pressing on nerve endings and affecting the senses of balance and hearing.
People with Meniere's disease typically suffer episodes of vertigo in which they feel as if they or their surroundings are spinning. Vomiting is common during severe attacks. The disorder causes ringing in the ears and, often, progressive hearing loss. In Van Gogh's time, there was no effective treatment, but Arenberg said most patients can be successfully treated today with drugs or surgery.
Arenberg said fear of the attacks apparently drove Van Gogh to paint frenetically whenever he felt well. "He was very worried that one of these attacks was going to come and he wasn't going to get better," he said.
Other experts said yesterday they doubted that Meniere's disease alone could explain Van Gogh's episodes of severe depression, his reports of hearing voices and his frequent suicide attempts.
"There are just a thousand reasons to support either manic-depressive illness or epilepsy or both," said Kay Jamison, a psychiatrist at Johns Hopkins School of Medicine and producer of an upcoming documentary film on Van Gogh.
She said the theory that Van Gogh was manic-depressive is supported by the fact that his illness was seasonal -- with episodes of depression in the winter and energetic, artistically productive periods in the summer -- and by his family history. She said his sister spent decades in an insane asylum, his younger brother committed suicide at 33 and his older brother, Theo, was psychotic at the end of his life.
She said most psychiatrists now discount earlier theories that Van Gogh was schizophrenic, because throughout his life he was able to paint and to function normally between attacks.
She predicted the debate will continue. "The man was so extraordinary, such a remarkable person, that it's interesting from a medical point of view," she said. "At the end of the day, he was just a very singular man. There are always going to be many interpretations, like looking at a painting or reading a poem."